| National Provider Identifier [NPI]: | 1508988486 |
| Last Name Of The Provider | KAKUMANI |
| First Name Of The Provider | SRINIVASA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 301 N 8TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 627011041 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 2245 |
| Number Of Medicare Beneficiaries | 619 |
| Total Submitted Charge Amount | 239240.43 |
| Total Medicare Allowed Amount | 170330.1 |
| Total Medicare Payment Amount | 128152.7 |
| Total Medicare Standardized Payment Amount | 133985.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 55 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 559.65 |
| Total Drug Medicare AllowedAmount | 531.81 |
| Total Drug Medicare PaymentAmount | 518.77 |
| Total Drug Medicare Standardized Payment Amount | 518.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 2190 |
| Number Of Medicare Beneficiaries With Medical Services | 619 |
| Total Medical Submitted Charge Amount | 238680.78 |
| Total Medical Medicare Allowed Amount | 169798.29 |
| Total Medical Medicare Payment Amount | 127633.93 |
| Total Medical Medicare Standardized Payment Amount | 133466.8 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 107 |
| Number Of Beneficiaries Age 65 to 74 | 252 |
| Number Of Beneficiaries Age 75 to 84 | 193 |
| Number Of Beneficiaries Age Greater 84 | 67 |
| Number Of Female Beneficiaries | 331 |
| Number Of Male Beneficiaries | 288 |
| Number Of Non Hispanic White Beneficiaries | 592 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 477 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 142 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 51 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.791 |